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Provincial governments have taken a prominent role in the development of national health policy in Canada. Saskatchewan is the first province of note; in 1920, its provincial government pooled communal resources to form Union Hospital Districts in rural towns, and in 1946, implemented the Hospital Services Plan. This program provided payment for hospital services in the province and served as the impetus for proper hospital service financing. Eventually, the implementation of the National Hospital and Diagnostic Services Act established a 50/50 funding scheme, in which the federal government would match provincial expenditures for providing hospital services. Fund matching was contingent upon the province meeting requirements about the scope of services and universal coverage. Other provinces followed Saskatchewan's Hospital Services Plan as a model for hospital payment plans. The Medical Care Act once more influenced provincial government's decisions in national health policy. Under this act, the federal government matched provincial expenditures at roughly a 50% rate for physician services. Other provinces dealt with physician balance billing independently. Consequently, physicians who wanted to pursue balance billing were required to opt out of the government-sponsored plan. Physicians had two options: they could either accept the government rate as payment, or they could practice outside of the insurance program entirely and receive no payments from the government. As such, the Act ended up covering clinic services as well.